MEDICARE: AQSA SHAUKAT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH22038	FL

General Provider Information

NPI Number	:	1629462130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AQSA SHAUKAT

Provider Business Mailing Address
First Line	:	3300 S UNIVERSITY DR FL 33328
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33328-2004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 S UNIVERSITY DR FL 33328
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33328-2004
Country	:	US
Telephone Number	:	954-372-5309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	07/25/2024

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